Provider Demographics
NPI:1760781629
Name:BEDLINGTON, MARTHA M (PHD ; LCMHC)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:M
Last Name:BEDLINGTON
Suffix:
Gender:F
Credentials:PHD ; LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34004 16TH AVE S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8903
Mailing Address - Country:US
Mailing Address - Phone:253-874-3630
Mailing Address - Fax:253-838-1670
Practice Address - Street 1:34004 16TH AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8903
Practice Address - Country:US
Practice Address - Phone:253-874-3630
Practice Address - Fax:253-838-1670
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60152866101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health